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The "3M" Approach to Cardiovascular Infections: Multimodality, Multitracers, and Multidisciplinary
Martina Sollini1, Raffaella Berchiolli2, Roberto C Delgado Bolton3
1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy.
Insights
Diagnosing cardiovascular infections requires integrating clinical, microbiological, and imaging data. A Multimodality, Multitracer, and Multidisciplinary (3M) approach improves early detection and patient outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
- Nuclear Medicine
Background:
- Cardiovascular infections pose significant health risks, leading to high morbidity and mortality.
- Prompt diagnosis and treatment are essential for improving patient prognosis.
- Current diagnostic methods often require integrating multiple data sources.
Purpose of the Study:
- To review the evidence supporting a Multimodality, Multitracer, and Multidisciplinary (3M) approach for diagnosing cardiovascular infections.
- To highlight the role of advanced imaging techniques in detecting cardiac and vascular infections.
- To discuss the requirements for implementing a comprehensive diagnostic framework.
Main Methods:
- Review of existing data on cardiovascular infections and diagnostic strategies.
- Focus on multimodality imaging, including molecular imaging like white blood cell SPECT/CT and [18F]FDG PET/CT.
- Emphasis on the integration of clinical, microbiological, and imaging findings.
Main Results:
- Multimodality imaging enhances the sensitivity for detecting infections of heart valves, vessels, and devices.
- Advanced imaging allows for early identification of septic emboli and metastatic infections.
- The 3M approach, combining imaging, tracers, and multidisciplinary input, is crucial for accurate diagnosis.
Conclusions:
- A Multimodality, Multitracer, and Multidisciplinary (3M) approach is vital for effective cardiovascular infection diagnosis.
- Specialized equipment, protocols, and expertise are necessary for optimal imaging interpretation.
- Establishing a Cardiovascular Multidisciplinary Team Approach is key to selecting appropriate diagnostic tests.
Abstract:
Cardiovascular infections are associated with high morbidity and mortality. Early diagnosis is crucial for adequate patient management, as early treatment improves the prognosis. The diagnosis cannot be made on the basis of a single symptom, sign, or diagnostic test. Rather, the diagnosis requires a multidisciplinary discussion in addition to the integration of clinical signs, microbiology data, and imaging data. The application of multimodality imaging, including molecular imaging techniques, has improved the sensitivity to detect infections involving heart valves and vessels and implanted cardiovascular devices while also allowing for early detection of septic emboli and metastatic infections before these become clinically apparent. In this review, we describe data supporting the use of a Multimodality, Multitracer, and Multidisciplinary approach (the 3M approach) to cardiovascular infections. In particular, the role of white blood cell SPECT/CT and [18F]FDG PET/CT in most prevalent and clinically relevant cardiovascular infections will be discussed. In addition, the needs of advanced hybrid equipment, dedicated imaging acquisition protocols, specific expertise for image reading, and interpretation in this field are discussed, emphasizing the need for a specific reference framework within a Cardiovascular Multidisciplinary Team Approach to select the best test or combination of tests for each specific clinical situation.